Page 19 - Dementia-Care-Specialist-Toolkit
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The More
The answer options for the next 5 questions are Less often same often
“Less often,” “The same,” or “More often.”
▼ ▼ ▼
Social Isolation/Activity Restriction:
During the past four weeks, because of helping [CR],
would you say that you:
15. participated in church or religious activities. 2 1 0
16. visited with friends or family. 2 1 0
17. participated in group or organized activities. 2 1 0
18. engaged in volunteer activities. 2 1 0
19. went out to dinner, the theater, or a show. 2 1 0
Score _______ (Sum of items 15–19)
Exact cutting points for heightened caregiver risk have been determined for this tool. Answers
can help caregivers describe difficulties they are experiencing, and with repeated
administrations, it can be used to assess change in the care situation over time. However, scores
greater than 8 for Mastery, greater than 10 for Relationship Strain or Health Strain, or greater
than 5 for Social Isolation/Activity Restriction may indicate heightened risk and may warrant
further clinical investigation.
If score is > 8 for Mastery, > 10 for Relationship Strain or Health Strain, or > 5 for Social
Isolation/Activity Restriction, then refer to Alzheimer’s Los Angeles and refer to CAREGIVER
DEPRESSION/STRESS CARE PLAN.
If score is > 10 for Health Strain, then refer to CAREGIVER DEPRESSION/STRESS CARE PLAN AND
DIFFICULTY PROVIDING CARE BECAUSE OF YOUR HEALTH CARE PLAN.
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